Provider Demographics
NPI:1124363445
Name:GOVIND, MELANIE TERESA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:TERESA
Last Name:GOVIND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 S BASCOM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2652
Mailing Address - Country:US
Mailing Address - Phone:408-793-2032
Mailing Address - Fax:
Practice Address - Street 1:828 S BASCOM AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2652
Practice Address - Country:US
Practice Address - Phone:408-793-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical